ABVD vs BEACOPP escalated in advanced-stage Hodgkin's lymphoma: Results from a multicenter European study.
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Austria
Bleomycin
/ administration & dosage
Cyclophosphamide
/ administration & dosage
Dacarbazine
/ administration & dosage
Disease-Free Survival
Doxorubicin
/ administration & dosage
Etoposide
/ administration & dosage
Female
Follow-Up Studies
Hodgkin Disease
/ drug therapy
Humans
Italy
Male
Middle Aged
Neoplasm Staging
Prednisone
/ administration & dosage
Procarbazine
/ administration & dosage
Survival Rate
Vinblastine
/ administration & dosage
Vincristine
/ administration & dosage
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
12
02
2020
revised:
11
05
2020
accepted:
13
05
2020
pubmed:
19
5
2020
medline:
30
12
2020
entrez:
19
5
2020
Statut:
ppublish
Résumé
The optimal first-line treatment for advanced-stage Hodgkin's lymphoma (HL) is still a matter of debate. While ABVD is less toxic and as effective as other, more intensive chemotherapy regimens, escalated BEACOPP (BEACOPPesc) is superior to ABVD for initial disease control and prolonged time-to-relapse. However, this advantage is associated with higher rate of early and late toxicities. As most of these data have been accumulated from clinical trials, a retrospective analysis was conducted in a large database of patients treated outside clinical trials to investigate the advantages and disadvantages of these regimes in a real-world setting. From October 2009 to October 2018, 397 advanced-stage HL patients treated with either ABVD or BEACOPPesc were retrospectively assessed in 7 European cancer centers (2 Austrian and 5 Italian centers). Complete metabolic remission (CMR) by PET was achieved in 76% and 85% of patients in the ABVD and BEACOPPesc groups, respectively (p = .01). Severe adverse events occurred more frequently with BEACOPPesc than ABVD. At a median follow-up of 8 years, 9% of the patients who achieved CMR after BEACOPPesc relapsed compared to 16.6% in the ABVD group (p = .043). No statistical difference in progression free survival (PFS) was observed between the two cohorts overall (p = .11), but there was a trend towards a superior PFS in high-risk patients treated with BEACOPPesc (p = .074). Nevertheless, overall survival was similar between the two groups (p = .94). In conclusion, we confirm that ABVD is an effective and less toxic therapeutic option for advanced-stage HL. Although BEACOPP results in better initial tumor control, the long-term outcome remains similar between the two regimens.
Substances chimiques
Bleomycin
11056-06-7
Procarbazine
35S93Y190K
Vincristine
5J49Q6B70F
Vinblastine
5V9KLZ54CY
Etoposide
6PLQ3CP4P3
Dacarbazine
7GR28W0FJI
Doxorubicin
80168379AG
Cyclophosphamide
8N3DW7272P
Prednisone
VB0R961HZT
Types de publication
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1030-1037Informations de copyright
© 2020 Wiley Periodicals LLC.
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